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CMS RVU26D · Effective 2026-10-01

97535 in Austin

Office / nonfacility

$33.38

Base rate per service

Facility setting

Not available in this setting

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Physical medicine and rehabilitation

About 97535: Self-care and home management training, each 15 minutes

Direct, one-on-one training in daily living and home management skills, such as dressing or meal preparation, reported as a timed therapy service.

This service involves direct, one-on-one instruction that helps a patient manage personal care and home tasks safely. Typical content includes training in dressing, bathing, toileting, grooming, feeding, kitchen safety, and meal preparation. Instruction may address compensatory techniques after a stroke or joint replacement, energy conservation, or use of adaptive equipment such as reachers, sock aids, and tub benches. Occupational therapists commonly provide this training; physical therapists may also provide it when appropriate to the treatment plan. Settings include private practices, outpatient therapy clinics, and hospital outpatient departments.

Report this timed code for documented patient-directed self-care or home management training. Record the tasks practiced, the patient's assistance needs, the instruction and cues provided, and direct treatment minutes. Medicare uses total timed therapy minutes to determine the day's allowable units; code-specific minutes support how those units are allocated. Identify the therapy plan of care with the appropriate discipline modifier. This therapy service has no professional component to report with modifier 26. Under the therapy multiple procedure payment reduction, practice expense is reduced for the second and later therapy units furnished on the same day.

CMS billing rules for 97535

Professional and technical components
Therapy service: the professional component modifier does not apply.
Multiple procedures
Therapy multiple procedure payment reduction: practice expense is reduced for the second and later therapy units on the same day.

Where the value comes from

  • Work RVU0.45 · 46%
  • Practice expense (office) RVU0.51 · 53%
  • Malpractice RVU0.01 · 1%

3.9M

Medicare services in 2024 · #48 by national volume

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

97535 compared with similar codes

Office rates for Austin, from the same CMS release.

97530

Therapeutic activities

One-on-one, each 15 minutes

$36.22

97535 teaches specific ADL and home management skills; 97530 uses dynamic activities to improve functional performance. Select the code that matches the documented treatment.

97537

Reintegration training

Community or work skills

$32.97

97537 addresses community or workplace participation, such as using public transportation or practicing workplace routines. 97535 addresses personal care and home management tasks.

97542

Wheelchair training

Assessment, fitting, and use

$31.91

Wheelchair propulsion and management training belongs to 97542. Teaching a patient to perform personal care tasks while seated in a wheelchair may instead support 97535.

97550

Caregiver training

Initial 30 minutes

$53.91

97550 describes qualifying caregiver training without the patient present, beginning with the first 30 minutes. 97535 is direct, one-on-one training of the patient in self-care or home management.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 97535 is $30.84—$2.54 lower than the $33.38 rate in Austin. Both use the same code, release and participation basis.

97535 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $33.38

  2. Beaumont

    $30.84

    $2.54 lower than Austin

  3. Brazoria

    $32.29

    $1.09 lower than Austin

  4. Dallas

    $32.42

    $0.96 lower than Austin

  5. Fort Worth

    $32.25

    $1.13 lower than Austin

  6. Galveston

    $32.34

    $1.04 lower than Austin

  7. Houston

    $32.53

    $0.85 lower than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 97535 ranges from $29.84 in Arkansas to $41.43 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 97535

    Office

    $31.50

    Facility

    Unavailable

    $1.88 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 97535

    Office

    $36.02

    Facility

    Unavailable

    $2.64 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 97535

    Office

    $36.28

    Facility

    Unavailable

    $2.90 higher than Austin for the office setting.

  • Miami

    Florida · 97535

    Office

    $33.61

    Facility

    Unavailable

    $0.23 higher than Austin for the office setting.

  • Chicago

    Illinois · 97535

    Office

    $33.02

    Facility

    Unavailable

    $0.36 lower than Austin for the office setting.

  • Manhattan

    New York · 97535

    Office

    $36.32

    Facility

    Unavailable

    $2.94 higher than Austin for the office setting.

  • Alaska*

    Alaska · 97535

    Office

    $40.87

    Facility

    Unavailable

    $7.49 higher than Austin for the office setting.

  • Alabama

    Alabama · 97535

    Office

    $30.12

    Facility

    Unavailable

    $3.26 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 97535

    Office

    $29.84

    Facility

    Unavailable

    $3.54 lower than Austin for the office setting.

  • Arizona

    Arizona · 97535

    Office

    $31.82

    Facility

    Unavailable

    $1.56 lower than Austin for the office setting.

  • Bakersfield

    California · 97535

    Office

    $34.19

    Facility

    Unavailable

    $0.81 higher than Austin for the office setting.

  • Chico

    California · 97535

    Office

    $34.13

    Facility

    Unavailable

    $0.75 higher than Austin for the office setting.

  • El Centro

    California · 97535

    Office

    $34.14

    Facility

    Unavailable

    $0.76 higher than Austin for the office setting.

  • Fresno

    California · 97535

    Office

    $34.13

    Facility

    Unavailable

    $0.75 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 97535

    Office

    $34.13

    Facility

    Unavailable

    $0.75 higher than Austin for the office setting.

  • Madera

    California · 97535

    Office

    $34.13

    Facility

    Unavailable

    $0.75 higher than Austin for the office setting.

  • Merced

    California · 97535

    Office

    $34.13

    Facility

    Unavailable

    $0.75 higher than Austin for the office setting.

  • Modesto

    California · 97535

    Office

    $34.13

    Facility

    Unavailable

    $0.75 higher than Austin for the office setting.

  • Napa

    California · 97535

    Office

    $38.60

    Facility

    Unavailable

    $5.22 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 97535

    Office

    $35.79

    Facility

    Unavailable

    $2.41 higher than Austin for the office setting.

  • Redding

    California · 97535

    Office

    $34.13

    Facility

    Unavailable

    $0.75 higher than Austin for the office setting.

  • Rest Of California

    California · 97535

    Office

    $34.13

    Facility

    Unavailable

    $0.75 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 97535

    Office

    $34.26

    Facility

    Unavailable

    $0.88 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 97535

    Office

    $35.56

    Facility

    Unavailable

    $2.18 higher than Austin for the office setting.

  • Salinas

    California · 97535

    Office

    $35.42

    Facility

    Unavailable

    $2.04 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 97535

    Office

    $36.04

    Facility

    Unavailable

    $2.66 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 97535

    Office

    $40.63

    Facility

    Unavailable

    $7.25 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 97535

    Office

    $40.62

    Facility

    Unavailable

    $7.24 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 97535

    Office

    $41.43

    Facility

    Unavailable

    $8.05 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 97535

    Office

    $41.38

    Facility

    Unavailable

    $8.00 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 97535

    Office

    $34.87

    Facility

    Unavailable

    $1.49 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 97535

    Office

    $36.22

    Facility

    Unavailable

    $2.84 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 97535

    Office

    $35.49

    Facility

    Unavailable

    $2.11 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 97535

    Office

    $36.58

    Facility

    Unavailable

    $3.20 higher than Austin for the office setting.

  • Stockton

    California · 97535

    Office

    $34.13

    Facility

    Unavailable

    $0.75 higher than Austin for the office setting.

  • Vallejo

    California · 97535

    Office

    $38.58

    Facility

    Unavailable

    $5.20 higher than Austin for the office setting.

  • Visalia

    California · 97535

    Office

    $34.13

    Facility

    Unavailable

    $0.75 higher than Austin for the office setting.

  • Yuba City

    California · 97535

    Office

    $34.13

    Facility

    Unavailable

    $0.75 higher than Austin for the office setting.

  • Colorado

    Colorado · 97535

    Office

    $33.60

    Facility

    Unavailable

    $0.22 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 97535

    Office

    $34.08

    Facility

    Unavailable

    $0.70 higher than Austin for the office setting.

  • Delaware

    Delaware · 97535

    Office

    $32.24

    Facility

    Unavailable

    $1.14 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 97535

    Office

    $32.89

    Facility

    Unavailable

    $0.49 lower than Austin for the office setting.

  • Rest Of Florida

    Florida · 97535

    Office

    $31.82

    Facility

    Unavailable

    $1.56 lower than Austin for the office setting.

  • Atlanta

    Georgia · 97535

    Office

    $32.78

    Facility

    Unavailable

    $0.60 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 97535

    Office

    $30.62

    Facility

    Unavailable

    $2.76 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 97535

    Office

    $34.59

    Facility

    Unavailable

    $1.21 higher than Austin for the office setting.

  • Iowa

    Iowa · 97535

    Office

    $30.75

    Facility

    Unavailable

    $2.63 lower than Austin for the office setting.

  • Idaho

    Idaho · 97535

    Office

    $30.86

    Facility

    Unavailable

    $2.52 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 97535

    Office

    $31.37

    Facility

    Unavailable

    $2.01 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 97535

    Office

    $31.10

    Facility

    Unavailable

    $2.28 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 97535

    Office

    $33.22

    Facility

    Unavailable

    $0.16 lower than Austin for the office setting.

  • Indiana

    Indiana · 97535

    Office

    $30.98

    Facility

    Unavailable

    $2.40 lower than Austin for the office setting.

  • Kansas

    Kansas · 97535

    Office

    $30.60

    Facility

    Unavailable

    $2.78 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 97535

    Office

    $30.48

    Facility

    Unavailable

    $2.90 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 97535

    Office

    $31.44

    Facility

    Unavailable

    $1.94 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 97535

    Office

    $30.43

    Facility

    Unavailable

    $2.95 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 97535

    Office

    $36.28

    Facility

    Unavailable

    $2.90 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 97535

    Office

    $33.47

    Facility

    Unavailable

    $0.09 higher than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 97535

    Office

    $33.96

    Facility

    Unavailable

    $0.58 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 97535

    Office

    $32.73

    Facility

    Unavailable

    $0.65 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 97535

    Office

    $30.91

    Facility

    Unavailable

    $2.47 lower than Austin for the office setting.

  • Southern Maine

    Maine · 97535

    Office

    $32.12

    Facility

    Unavailable

    $1.26 lower than Austin for the office setting.

  • Detroit

    Michigan · 97535

    Office

    $32.03

    Facility

    Unavailable

    $1.35 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 97535

    Office

    $30.96

    Facility

    Unavailable

    $2.42 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 97535

    Office

    $32.66

    Facility

    Unavailable

    $0.72 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 97535

    Office

    $31.35

    Facility

    Unavailable

    $2.03 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 97535

    Office

    $31.58

    Facility

    Unavailable

    $1.80 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 97535

    Office

    $30.04

    Facility

    Unavailable

    $3.34 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 97535

    Office

    $29.94

    Facility

    Unavailable

    $3.44 lower than Austin for the office setting.

  • Montana**

    Montana · 97535

    Office

    $32.40

    Facility

    Unavailable

    $0.98 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 97535

    Office

    $31.14

    Facility

    Unavailable

    $2.24 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 97535

    Office

    $32.20

    Facility

    Unavailable

    $1.18 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 97535

    Office

    $30.88

    Facility

    Unavailable

    $2.50 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 97535

    Office

    $33.06

    Facility

    Unavailable

    $0.32 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 97535

    Office

    $36.09

    Facility

    Unavailable

    $2.71 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 97535

    Office

    $34.60

    Facility

    Unavailable

    $1.22 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 97535

    Office

    $31.05

    Facility

    Unavailable

    $2.33 lower than Austin for the office setting.

  • Nevada**

    Nevada · 97535

    Office

    $32.36

    Facility

    Unavailable

    $1.02 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 97535

    Office

    $36.87

    Facility

    Unavailable

    $3.49 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 97535

    Office

    $34.76

    Facility

    Unavailable

    $1.38 higher than Austin for the office setting.

  • Queens

    New York · 97535

    Office

    $36.61

    Facility

    Unavailable

    $3.23 higher than Austin for the office setting.

  • Rest Of New York

    New York · 97535

    Office

    $31.45

    Facility

    Unavailable

    $1.93 lower than Austin for the office setting.

  • Ohio

    Ohio · 97535

    Office

    $30.92

    Facility

    Unavailable

    $2.46 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 97535

    Office

    $30.50

    Facility

    Unavailable

    $2.88 lower than Austin for the office setting.

  • Portland

    Oregon · 97535

    Office

    $34.44

    Facility

    Unavailable

    $1.06 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 97535

    Office

    $32.23

    Facility

    Unavailable

    $1.15 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 97535

    Office

    $33.43

    Facility

    Unavailable

    $0.05 higher than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 97535

    Office

    $30.98

    Facility

    Unavailable

    $2.40 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 97535

    Office

    $32.58

    Facility

    Unavailable

    $0.80 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 97535

    Office

    $33.21

    Facility

    Unavailable

    $0.17 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 97535

    Office

    $31.05

    Facility

    Unavailable

    $2.33 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 97535

    Office

    $32.18

    Facility

    Unavailable

    $1.20 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 97535

    Office

    $30.69

    Facility

    Unavailable

    $2.69 lower than Austin for the office setting.

  • Utah

    Utah · 97535

    Office

    $31.34

    Facility

    Unavailable

    $2.04 lower than Austin for the office setting.

  • Virginia

    Virginia · 97535

    Office

    $32.01

    Facility

    Unavailable

    $1.37 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 97535

    Office

    $32.58

    Facility

    Unavailable

    $0.80 lower than Austin for the office setting.

  • Vermont

    Vermont · 97535

    Office

    $32.06

    Facility

    Unavailable

    $1.32 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 97535

    Office

    $33.42

    Facility

    Unavailable

    $0.04 higher than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 97535

    Office

    $36.96

    Facility

    Unavailable

    $3.58 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 97535

    Office

    $31.45

    Facility

    Unavailable

    $1.93 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 97535

    Office

    $30.31

    Facility

    Unavailable

    $3.07 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 97535

    Office

    $32.31

    Facility

    Unavailable

    $1.07 lower than Austin for the office setting.

See how rates vary across the country

97535 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$29.84

$40.87

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$40.871
AL$30.121
AR$29.841
AZ$31.821
CA$34.13–$41.4329
CO$33.601
CT$34.081
DC$36.281
DE$32.241
FL$31.82–$33.613
GA$30.62–$32.782
GU$34.591
HI$34.591
IA$30.751
ID$30.861
IL$31.10–$33.224
IN$30.981
KS$30.601
KY$30.481
LA$30.43–$31.442
MA$33.47–$36.282
MD$32.73–$36.283
ME$30.91–$32.122
MI$30.96–$32.032
MN$32.661
MO$30.04–$31.583
MS$29.941
MT$32.401
NC$31.141
ND$32.201
NE$30.881
NH$33.061
NJ$34.60–$36.092
NM$31.051
NV$32.361
NY$31.45–$36.875
OH$30.921
OK$30.501
OR$32.23–$34.442
PA$30.98–$33.432
PR$32.581
RI$33.211
SC$31.051
SD$32.181
TN$30.691
TX$30.84–$33.388
UT$31.341
VA$32.01–$36.282
VI$32.581
VT$32.061
WA$33.42–$36.962
WI$31.451
WV$30.311
WY$32.311

Explore 97535 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 97535 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$36.72

$33.38 × 110% = $36.72

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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Physical therapy

Compare selected outpatient therapy base rates before claim-level adjustments.

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 97535 in Austin.

PPRRVU2026_Oct_nonQPP.csv

12,891

Code
97535
Physician work
0.45
Practice expense
0.51
Malpractice
0.01

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 97535 in Austin
ComponentRVULocality factorAdjusted
Physician work0.45× 1.0020.4509
Practice expense0.51× 1.0580.5396
Malpractice0.01× 0.8860.0089
Total RVUs0.9993
Conversion factor× 33.4009

Office / nonfacility rate, Austin$33.38

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 97535 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.451.002
Practice expense0.511.058
Malpractice0.010.886

(0.45 × 1.002 + 0.51 × 1.058 + 0.01 × 0.886) × $33.4009 = $33.38

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

97535 · Office / nonfacility

$33.38

Effective 2026-10-01

The base rate is $0.60 higher than on 2025-10-01, moving from $32.78 to $33.38 (1.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $32.78changed to$33.38

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.53 changed to 0.51
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $32.78

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$33.38Not available in this settingRVU26D
2026-07-01$33.38Not available in this settingRVU26C
2026-04-01$33.38Not available in this settingRVU26B
2026-01-01$33.38Not available in this settingRVU26A
2025-10-01$32.78Not available in this settingRVU25D
2025-07-01$32.78Not available in this settingRVU25C
2025-04-01$32.78Not available in this settingRVU25B
2025-01-01$32.78Not available in this settingRVU25A

97535 billing questions

How is this code different from 97530 therapeutic activities?

Use 97535 for instruction in a specific self-care or home task, such as dressing or using a tub bench. Use 97530 for dynamic activities, such as lifting or transfer practice, directed at improving functional performance rather than teaching that task.

Can time spent training a family member be counted?

Count only direct, one-on-one training furnished to the patient toward 97535. For qualifying training furnished to caregivers without the patient present, 97550 describes the first 30 minutes; 97551 covers additional 15-minute increments.

Which therapy modifier identifies the plan of care?

Use GO for an occupational therapy plan of care or GP for a physical therapy plan of care. Use GN if the service is furnished under a speech-language pathology plan of care.

How many units can be billed for a session?

Medicare determines the day's allowable timed therapy units from total direct timed therapy minutes. Document the actual minutes of 97535 separately so the units can be allocated to the services furnished.

Is instruction in adaptive equipment use reported here?

Yes, patient training in equipment used for daily living, such as a reacher or tub bench, can be reported with 97535. Use 97542 for wheelchair management training and 97760 for orthotic management and training.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 97535PPRRVU2026_Oct_nonQPP.csv, line 12,891 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet